Those that have had an ACL tear, what do you do different now to help protect yourself? Like riding with more control, being cautious on conditions of water and fatigue. Landing with more flex....I dont want to go through this again.

I recently narrowed up my snowboard stance after tearing both mcl's this past summer. I have noticed a huge improvement in how my knees feel after a long day of hard riding. I plan on trying a slightly narrower stance wakeboardin as well. Oh and knee brace on both knees.

Go to Dick's Sporting Goods and get yourself a Bocce ball. Blow that puppy up and do some one leg squats and other exercises you did in PT for the knee you tore as well as the other. Keeping that knee strong will be the best thing for you and your confidence!! Ive been using mine everyday since my last injury and my knees have never been stronger and have never felt soo good!

Balance and strength are key. My PT instructor consistently pushed my muscles to their limits to make me stronger, and after the weightlifting and training I had to work on balance. She said many injuries come when your muscles and body are tired, and can't support your knees. So, I still work on my legs muscles at the gym all the time and try to work on balance as well. The bocce ball and other devices really help out. Finally, I had to do a lot of plyometrics (sp?) to teach myself how to land properly. Land with my knees bent, on balance, and with my weight distributed as well as possible so no one body part is taking the full force of a landing. Also, I have been doing a lot more interval training verses pure cardio workouts. From what I have read (Please dont shred me apart if I am wrong), Cardio actually can decrease the muscle mass in your legs. interval training is a shorter workout, still cuts down body fat, but retains muscle mass a lot better then only doing cardio all week long.

for interest sake I was wondering if anyone has considered wearing Knee braces before injuring themselves,we have been wake boarding for the last four years and in the last 18 months my own family have had three major surgerys,my daughter who was 16 has had a left and a right acl reco and myself completely detaching all 4 ligiments aswel as a break to my tibia in my right knee.after watching countless other knee injurys this summer,including one current world champion is it time to take a different outlook to the way we protect ourselves?

I continually work on building hamstring and glute strength an flexibility to match or exceed my quads. this has added more lateral stability to my knees, and i believe allows me to keep landing inverts and raleys out in the flats,....I'm in my mid 40's, been riding hard for 20 years knock on wood !

I agree with Luker and add that if your not "feeling" it that day, dont push yourself to ride hard. Every major injury I have ever had was when I wasn't super motivated to be out riding or progressing.

Andrea and Luker have made good points. Riding when you are tired or not in "wakeboard shape" is a sure recipe for potential injury. This is especially true when you start to build a bag of tricks and have not ridden in a while. A common thing many people want to do is pick right back up where they left off; which is a bad idea.

Also, Robot...you mentioned something called "riding in control" this could not be more True! Almost every rider I know has holes in his trick list at some level. Those TS FS 3's...can you do a SW HS BS 1? I tore my ACL because of this exact reason (IMHO). I had learned a whirly before ever learning a BS 1 or bs3. I was just hucking myself rather than knowing all the basics and board/handle control. Now when I teach people I really try to emphasis learning at least 3 180's wake to wake before going inverted (which every new rider wants to do). HS FS, TS FS and Cab. This helps them learn how to control the board and ride a little more controlled. IMHO this is a BIG BIG reason why people are so anal about grabbing the board. It truly demonstrating a control and mastery of a trick as opposing to simply hucking a trick.

I agree sometimes things happen. I'm a strength and conditioning coach so leg strength, balance and knowing how to land where my specialities. However when I tore my ACL I was really tired that day and didn't want to go off the big kicker but I did it anyway because my wife told me to go big. Well if I'm tired or don't feel like doing something I won't do it anymore. Just my experience.

Dustin - get a brace. There may be no evidence it will help, but at the very least wearing a brace will give you a little more confidence, which is really the biggest stumbling block when you're coming back from an injury. That said, I have no doubt my brace has saved my knee in the past. I can't think of any possible negative to wearing a brace?!! so why wouldn't you!

Alice, agreed. I'm probably going to get a CTI Pro Sport custom. Just hope my insurance will cover it. But if not, the docs said they would give me special pricing equal to what they would get as a medical provider.

Don't you love our system... We'll jack the price of the brace if we're billing your insurance (cause they got all the money in the world right?), but if you pay out of pocket we'll cut you a deal... That's why everything's gotten so expensive and insurance is so hard to get... sorry, end of rant.

Also second stop riding when you're tired! I was in minute 40 of a marathon set without many falls. Was working on adding a solid indy to my tantrum and poking the HSFS Melan 3. Thought, eh, I'll do a roll to revert at the end of the set and then game over...

I got kinda down after tearing my ACL twice but I met Shawn Watson and asked him how he stays injury free now. (he tore the same acl twice in one year once a while ago but has been good since) He told me the main thing he tries to do is when hes coming out of a spin or invert he will just bail if he cant stomp it and try not to sketch out of it or land unbalance. Also I bought two braces and havent even had a bad tweak since weaeing them but be sure they dont slide out of place!!! that is a sure fire way to get injured. I think most injuries when you think about it are when u land out of position. I remember everytime I have tweaked a knee and when I tore my acl I landed front foot heavy.

Hey Dustin, I agree your system sux, but things are a little different here in Australia. Having said that I'll probably be paying out of my own pocket for my next brace. I'm 2 months out of acl surgery no 2. Were you in aus a few years ago? I think I met you at the UQ club?

I completely disagree with wearing braces when you have fully recovered from an injury or have not had an injury.

I think we'd all agree that wakeboarding has certain physical dynamics that can't be recreated in plyos, cardio, interval or trampoline training. If you don't agree with that just stop reading. I also believe that as the season progress that my body gets in "riding shape". Meaning my legs, knees and ankles get accustomed to landings and get stronger. As someone who has been through ACL recon, rehab and is back riding it's my opinion and that of my therapist that a brace just compensates for something your body doesn't have. If you wear a brace your body has no need to get stronger in certain areas. Given that a brace will not prevent you from having a injury, what is the point of wearing one? Especially if you know that a brace is going to eliminate the need for your body to build up certain areas.

Get in shape at your house or gym. Use the first month of the season to get your body used to riding again. Don't huck yourself. Don't wear a brace if you have fully recovered.

My brace caused my 2nd ACL tear. Had I not been wearing the brace at the time of the fall, I would have not been injured.

I agree that, once fully recovered, the brace is no longer needed. However, the time period as to when to get out of the brace during recovery is debatable and should be determined on a case by case basis.

Im currently recovering from a acl reconstruction and will wear a knee brace for this summer. My doctor told me before the surgery that the patella tendon they put in there was actually weaker than your normal acl for about a year and a half and then eventually would become stronger than the original one. Based on this information and how I feel toward summers end, I will most likely end up only wearing a brace for this summer, and maybe the winter for skiing and then stop using it.

Great thread. Now does the knee injury mainly happen to your lead knee or the other? does HS/TS differ? I have been noticing after doing a TS front roll/scarecrow/elephant that my lead knee tends to take the most abuse when I STOMP the landing (the good stomp) Would those that have torn say that with exercise and wearing a knee brace be preventative if you are lucky enough not to have injured a knee yet?

"Given that a brace will not prevent you from having a injury"... I disagree also!! I KNOW my brace has saved me before. Though I have to say, if you're paying big dollars for a custom brace, and not using the biggest extension stops you can get for it, then you're probably wasting your time. You will also need to get it refitted if the shape of your leg changes.

A brace doesn't hold you back in any way, and doesn't compensate for anything. It is just there, and you don't even notice it, or do anything differently until the moment when you're about to land badly and it stops your knee from going into the position that will destroy it...

Wearing a brace will not stop your leg from gaining condition throughout the season - custom braces don't 'support' like a neoprene brace. they just provide a rigid framework that will prevent your knee from moving outside its boundaries. I really don't see how that would prevent you from building up your legs?! Have you ever worn one bizzuck?

You are correct in the way the brace performs, Alice. However, the best custom brace is only as strong as it's weakest link.

My brace that caused my 2nd ACL tear was a completely custom brace built by a very reputable company. It saved me a few times from re injuring my knee as I was building my strength on the water.

However, all it took was one simple crash where I hit the water just right. I fell from doing an air scarecrow, and I fell at an angle where the water blew two of the straps off of the brace. The brace then turned 90 degrees and bent, thus dislocating my knee and tearing my ACL.

Had I not had the brace on, I would not have been injured.

I completely agree with you about the custom brace being a rigid frame work. The entire idea is to not become dependent on the brace. I am a firm believer that you should wear the brace for a limited time during rehab until you are back to full strength. Once you are at full strength, it is time to ditch the brace.

Sounds like a nasty unfortunate accident McFly. I definitely agree straps seem to be the weakest link. I think your case is unusual though.

Despite having just blown out my knee for the 2nd time, while wearing a brace, I'm still a strong believer in wearing them ALL the time, not just during recovery. It's always just that freak moment in time when these accidents happen, and they don't just occur when you're still recovering your full strength. They happen ANY time. I believe my brace didn't save me on this occasion because the fit had started to change - i'd felt it didn't feel right for a few months and just hadn't gotten around to getting it re-fitted. It did however reduce other damage in my knee - despite tearing my ACL, I had no meniscus damage or bone bruising (ie way less extra damage than my first injury). Recovery has been dead easy in comparison this time.

Dustin, I only realised it was you because JB mentioned seeing you post on here It's definitely been a while! There's definitely always plenty of new people at the club, but most of the main crew are still around - just not as regularly i guess. You should come back for a holiday!

a good way to help prevent alot of knee injuries is by strengthening your gluteus medius in your hip. If this muscle is weak your knee will have a tendency to move inward upon landing, which is one of the components of a torn acl, the other being external rotation (your foot being turned outward) which is already happening with many people who have a very ducked stance. This muscle can be strengthened by a exercises known as the clam series, if you know a PT, they should know what these are, if not do some research on them. note: you will most likely not enjoy these while your doing them despite them appearing to be really easy

As stated earlier plyos will help out alot as well. Simple exercises such as jumping onto and off of a 12"-30" box while focusing on landing soft with your knees over top of you feet and not out over your toes, but more importantly landing with a major focus on keeping your knees out over top of you outside ankle bone. This help train your muscles to land in this position normally, causing the least amount of stress on the ligaments. This can be advanced to jumping onto of off of a shorter box and landing on only one leg with the knee over top of the foot, and not letting it move inward. When landing for both exercises you should land with about a 30 degree bend in the knee and hold the position for ~2 seconds. This is just one basic example that you should be able to do anywhere.

Also if you lift, at least make an attempt to do research to make sure your doing proper form, because if your not you really predisposing yourself to an injury. Just because you know some guy who lifts all the time doesnt necessarily mean he know what proper form is

10 months out of surgery and my knee feels like crap today Hahah... just thought I'd share, LOL! I've been shredding pretty hard since about 5.5 months on a CTI Custom Pro Sport but still, some days are better than others. Use, weather, altitude, sleep positions...all sorts of things play a factor into how much pain I have day to day. Lame. But it feels great when I shred which tells me part of my problem is in my noggin'

^ wrong again. Parks had one knee routinely scoped and it got infected and he had basically had full reconstruction because of it (almost lost his leg). The other knee was blown when he hit a rail and landed on the grass. The guy never blew a knee on the wake.

Murray did wear a CTI 2 right after he had ACL, PCL, and MCL reconstruction.

Those guys may not wear braces now, but they also get to ride every day, which your average weekend warrior doesn't. Most normal people will only ride a couple of times a week max, and it's impossible to get the sort of riding condition and muscle control you're talking about bizzuck, when you're not riding that often.

Most people don't have the time to dedicate themselves to strengthening their knees in the gym either.

Linemen's knees take a lot more abuse than an average wakeboarders, also pros in the Nfl dont wear them all the time (which is basically the same with professional wakeboarders, even though there are a few exceptions)

I've never blown a knee but I've snapped a fib in two places and blown a shoulder pretty badly.

Here's another tip - dont, or be extra careful when you ride someone elses gear. Both of my major injuries happened riding someone elses gear. Snapped fib came from bindings being too big and the shoulder came from trying to do hard  out of the gate instead of getting a feel for the board i just switched to (I snapped my board previous set and just jumped right in on a friends board).

Parks - 12 Honkeys: Biggest. Indy Glide. Ever.

That guy beat his body up before anyone could really appreciate just how good he really was. He was way ahead of his time. Way.

As a preventative measure, Chris hit it with his "single leg squats comment." Not only is it a great exercise, it's an important assessment of your lower body imbalances. If glutes aren't all firing, and if all muscle groups that control the hip aren't recruiting and pulling with equal control and tension, your chances of a knee injury in an out of control landing can be increased.

If anyone is interested in what to look for, feel free to email me, or find a good trainer at your gym.

I tore an ACL, wore the brace for my first 6mo back and never wore it again. My wife tore her ACL 2yrs ago and still wears her's.

The key difference is that I never had "bad knees" to begin with. I came down wrong once and there she blew. My wife has always had knee problems. After her ACL healed she still had the pre-existing problems.

If wearing a brace makes you more comfortable going big, by all means, shred it up. For me, I spend too much time fiddling with the straps and worrying about it twisting while riding to appreciate it.

Thanks for the thoughts, any ideas on stance angles. Caleb mentions external rotation being in play, but with a ducked stance, there would be less resistance to external rotation than 0 degrees. I narrowed my set up to allow my knees to to each other based on advice off of LearnWake, a few weeks prior to the tear

It doesn't make sense to me that braces generally protect against injury, but it does make sense to me that they can keep your knee in flexion when unloaded in the air--which means the knee is in flexion on landing. Since extension is the high-risk position for wakeboarding, I'm thinking a brace can help prevent injuries riding.

Any thoughts on this point? If prevention of going into extension is the primary issue, any ideas on CTI v. Donjoy? If they both prevent unloaded extension equally well, then it probably comes down to comfort, migration, and straps staying in place?

Richard, not sure about the donjoy, but with the cti the extention stops come seperate, and you have to put them in yourself. I think there are 3 different sizes? I've always used the largest, and as you say, I think it is THE most important/useful part of wearing a brace. It's annoying if you're at cable and have to walk because it means you have to limp basically (cos you can't straighten your leg), but it's worth it.

After my first knee surgery, I used the Don Joy. The Don Joy is the brace that actually caused my 2nd ACL tear. After the 2nd surgery, I used the CTi2 on each knee until I was back to full strength. I preferred the CTi2s. They seemed to fit and stay in place better than the Don Joy.

A trick for all you guys out there- I put my brace on like normal and then wrap electrical tape around the straps 2 times a peice and it never ever moves.... I can ride boat or cable all day and it doesnt budge.

A brace is definitely NOT a guarantee that you won't injure or re-injure your knee... nothing is! Basically, a knee brace is just meant to provide additional exoskeletal support to the knee. It is intended to assist in the stability and correct alignment of the knee (and the 4 major ligaments of the knee - ACL, PCL, LCL & MCL) against damaging forces. Basically, it keeps the femur aligned properly with the tibia through your knee's full range-of-motion (during both flexion and extension and when weight-bearing and not). Most action sports, especially wakeboarding, put a lot of unnatural forces on your knees. For instance, your body wasn't designed to absorb landings from a huge double-up into chop. So, a knee brace helps to absorb these forces by providing additional exoskeletal support to your knee by caging your ligaments in place and assisting in keeping your femur and tibia in correct alignment and extension control, thus, reducing your chances of blowing out your knee. In addition, it keeps you more confident which can reduce potential injuries to other areas of your body that become vulnerable due to you compensating for your injured knee.

Suggestions for brace slippage - I would suggest you dunk your brace in the water a few times before you put it on. This will help with any brace manufacturer's straps. Dry straps tend to shrink up a bit and then stretch out as soon as they get wet, thus making them looser. So, if you wet them first, before you apply the brace, you won't have them stretching out and loosening as you ride. Sounds simple - but it helps! Also, if you have a CTi or CTi OTS... make sure you get an AMS (anti-migration system) wrap for it. It is a circumferential padding configuration that really helps lock the brace in place. I think every single team rider is now using this system. It is free is you ask for it when you order the brace, and not too much $ if you already have a CTi. It is worth the few bucks!

Just to chime in, I've blown my ACL and got my strength and flexibility back, so I don't need a brace, period. A brace is a tool to overcome a deficiency, no more, no less. If a brace was what some people in this discussion made it out to be, every rider would wear one.

Plyometrics, strength training, and maintaining flexibility are infinitely more important than a brace. In fact, if you don't need one, a brace is strictly a liability. I don't need one and I can prove it in the gym any day of the week.

Well guys no a brace wont insure your prevention of re injury, but it will greatly reduce the occurence.Brett you hit alot of good points. Truth be told I listened to my doctor and after an acl tear and recon, did not wear a brace. The following summer after 6 months of relentless rehab and training, tore it again. After this surgery I said screw my doctor and did what I thought was best and bought a pair of braces. Havent had an injury or a single tweak since. 3 years. not even a knee tweak and I am 200lbs and ride hard. Truth is many doctors are very arrogant about how they perform surgery and view a brace as a crutch and feel its says they didnt do their job correclty also. Think of it like this, how many doctors really legitimately understand what wakeboarding is and the stresses it puts on the knees. I would argue it is harder on them than any other sport. Really to wear a brace or not is a question you shouls ask your ortho not your surgeon. Its like asking a school tutor if you should go seek more help right after they help you.

Right on Brett. I think you and Mason hit the nail on the head (I had the same experience with my doctor). BTW I am loving that Anti Migration strap Brett...I just cut the extra length (that usually wraps on itself(so I can leave it attached to the brace). Now it just barely wraps around my calf...making getting the knee braces on much quicker. I like the idea of dunking the braces first too, I will definitely try that.

Brett, do you have any pics of the anti-migration wrap. I asked about it but my CTi rep told me it wasn't meant for watersports and that in a wet environment straps would work best when they are in direct contact with the skin.

^ The anti migration strap is just a oddly shaped piece of neoprene with a velcro strap that is wrapped just below the knee and runs down your shin. The brace fits on top of it.... and it works great in water and is in direct contact with the skin unless you're wearing a wetsuit... in which case it still works My CTI "Rep" had never even seen one of the braces to my knowledge... he acted like it was the first time he'd ever fitted one as well... I knew more about it than he did from Brett and the internet LOL

Alot of excellent points made here. The first key is to make sure that your legs are strong and the muscles around your knee can support the load and stress placed upon it. With that said i have been wearing Donjoy knee braces for quite some time. I got a Breg knee brace about a year ago as prevention for a previously torn ACL and although i didn't tear any ligaments i did break my tibial plateau 6 months ago. I truly believe that the brace saved my ligaments but the fit never seemed right and probably had alot to do with breaking my leg. On the other hand i also moto pretty hard and wear a Donjoy on my left leg that needs ACL reconstruction and it holds it very stable in both Wake and Moto. I have since recieved a brand spanking new Donjoy Defiance knee brace with all the bells and whistles (anti-migration, knee cups, power straps, chamois liners, active extension stops,air condoyle etc.) for my broken leg and the other is being ordered today (had to see what my insurance would cover). Everyone has their opinion but i will not ride without braces but hit the gym hard....and am really looking forward to get out on the water and dirt soon.

Unfortunately, every territory has different rep groups. Some reps are definitely better than others when it comes to CTi. Ossur actually manufactures 100s of products - ranging from Bionic prosthetic knees to simple casting tape- so it is tough for all the reps to be completely specialized on the CTi. That being said, it is definitely a focus of the company and the training for outside reps is being improved. Please feel free to hit me up with any questions as well, I will do my best to answer them as best and honestly as I can.

Luker did a good job of describing the AMS wrap. It is simply a piece of neoprene that wraps circumferentially around your calf and then shaped to follow the tibial portion of the frame. It is used in conjunction with the straps.

It is tough to generalize. My knees have a tendency to bend backwards (slightly double jointed) and i have dislocated the top of my fibula twice. I don't think any amount of strength training will stop my knees over extending and getting injured. So for me I would definitely wear a brace no matter how good my legs were feeling.